Provider Demographics
NPI:1932962966
Name:HARTLEY PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:HARTLEY PHYSICAL THERAPY PLLC
Other - Org Name:HARTLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TATE
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:903-363-3391
Mailing Address - Street 1:246 STUTTGART CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-3943
Mailing Address - Country:US
Mailing Address - Phone:903-363-3391
Mailing Address - Fax:
Practice Address - Street 1:3024 TEXAS AVE S
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5048
Practice Address - Country:US
Practice Address - Phone:903-363-3391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty